Author Topic: Coordination of Benefits and payment / adjustment posting  (Read 1882 times)


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Coordination of Benefits and payment / adjustment posting
« on: February 19, 2015, 12:05:18 PM »
One of the things I've watched over the years as an educator in this industry, is the lack of information out there on HOW payments are applied, adjustments are taken, etc. Mostly with claims that contain dual coverage (COB, Coordination of Benefits) Most of our education with COB focused on determining the primary payor, but then what?   Most billers don't even understand that there are 3 methods of COB calculation and understanding how a plan calculates benefits with dual coverage is vital so that you understand what the patient is responsible for and what the proper adjustments would be. Most courses and books I've seen on this subject don't teach COB methods of payment. 

PMRNC has created a series of "Test your Knowledge" quizzes which we utilize to gather information and find out what billers are missing from their education and how we can give them the exact information they need to learn. For a limited time only to help us gather data, we are offering our test your knowledge quizzes free. If you are interested in taking one of the quizzes below, please email me at   with your FULL name, email address and which quiz you are interested in taking.   PMRNC members can take all of the quizzes and view all of the sections that correspond with them by logging in at  Only members only will receive a full certificate of achievement with their quiz and a score of 85% or higher.

Here are the available quizzes.  Only one quiz per non member. Members can view and take all quizzes within the members only area.  YOU must send your FULL name, email address and specify which quiz you would like to take.  I will warn you that these quizzes are a bit difficult, they are created that way INTENTIONALLY,  so that we can better pin point the exact needs of all medical billers in what they need to learn!  The average % is posted next to the quiz. ONLY quizzes which had 100 or more takes will receive an average %.

1)  Payments and Adjustments   (Average score= 77%) 
2) HIPAA                                     (Average score = 72%   
3)  Coordination of Benefits - payments, adjustments and patient balance   (no average calculated to-date)

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers